Monday, 5 May 2014

First Step to the Journey that is UCTD



One day I woke up to what I thought would be a usual January day, but little did I know that my life would be set on a path of radical change. I went over mentally the things I had to do in the day. As I was drying myself I felt this pain in my left index finger. I looked at it and found the first 2 digits completely white and then I could not feel the finger. I was slightly panic stricken as I rubbed it and held it up in the air trying to get the blood circulating. I totally forgot I was standing shivering in the cold still a little wet from the shower.
It was a good 5 minutes before the whiteness started receding and I hastily got on warm clothes and properly looked at my hands. Now they had been kind of achy as they get when it is cold and I have done a lot of typing, but when I saw my hands that day I was surprised to see them puffy and swollen, fingers and palms too. I do not remember seeing them swollen before but surely this did not come on within the night! I decided to get myself an emergency appointment at the doctors’ surgery. A late morning appointment brought out the findings of swollen and painful joints not just of the hands but also wrists, feet and knees. I was told to rest up and have some Ibuprofen to reduce the inflammation. Review to be in 2 weeks. I thought that’s not too bad, once the swelling comes down I will be fine.
The 2 weeks went by fast and there was little improvement in the swelling and pain and difficulty of movement and I just about managed to get myself to work and back. I used to drive 40 miles each way to work and with painful hands it is hard to change gear and with painful feet using the pedals is equally hard. The doctor this time made an urgent appointment with the local rheumatologist since she felt this poly arthritis had to be explored.
The visit to the rheumatologist could not come fast enough I wanted some answers and some relief from all this pain. But all I got was keep having the Ibuprofen which at this point was 200mg 3 to 4 times a day and we shall do some blood tests. Come back in four weeks as the blood test results would have come. However, this medication was barely touching my pain levels and even my face tended to look puffy.
The next visit, I am looking for some explanation by now, was very much like the first. There is raised ANA and ESR but we will still the diagnosis as polyarthritis for now. You feel the pain is not controlled? Well we can hike up the Ibuprofen to 800mg 3 times a day. I was taken aback as the instruction for over the counter ibuprofen is maximum 200mg 4 times a day or some such low dose. I was told that this was for arthritis and being monitored so I could take that which was truly the maximum dose.
Oh yes that medication brings its own troubles. The reason for care and monitoring this drug is that it can cause many side effects and the commonest one being heartburn and acidity leading to ulcerations. So alongside, one needs to have some antacids. First I was given Ranitidine and that was ok for a few weeks, then it did not cover me till the next dose was due. Therefore antacid was changed to omeprazole, which was once a day. Meanwhile, I was also had some short sharp bursts of steroids to manage the severity of the pain and inflammation. Now one had to remember that you cannot take omeprazole within 6 hours of steroids. Also that side effect of omeprazole is muscle and bone pain. Ahhhh I am back a full circle it seems. We have medication and then we have medication to take care of the side effects of that first medication whose side effects are the same as your symptoms. This is the crazy world and now it has become my world.

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